Intraocular clip

ABSTRACT

An intraocular clip including first and second hook members extending generally coplanarly in opposite directions from a spine, the spine being formed with an attachment member attachable to ocular structure.

FIELD OF THE INVENTION

The present invention relates generally to eye implants for human eyesand, more particularly, to an intraocular clip that may be used to affixthe capsular bag to adjoining ocular tissue.

BACKGROUND OF THE INVENTION

As is well known in the art of cataract surgery, a continuouscurvilinear capsulorhexis is performed on the anterior capsule to removethe natural lens. The anterior capsule has a generally smooth surfacecontour except at the equator, where the zonules attach. In such a case,the IOL generally remains well centered postoperatively after thecontinuous curvilinear capsulorhexis. However, in certain cases, thecapsular bag may become decentered. For example, dehiscence or ruptureof some of the zonules may cause an uneven zonular tension anddecentration of the lens. If an artificial lens is situated within acapsular bag with partial zonular support, the IOL optic edge orelements of the haptic may be situated in the visual axis leading toblurred vision, monocular diplopia and optical aberrations. Contractionof the capsular bag by late fibrosis may further aggravate the visiondisturbances.

Capsular tension rings have been used in patients with unstable orabsent zonules during cataract surgery, with the aim of minimizing IOLdecentration. The capsular tension ring may stabilize the capsular bag,may reduce asymmetric zonular forces, and may reduce capsulardecentration during capsular contraction.

For example, capsular bag implants for stabilizing the capsular bag arecommercially available from such manufacturers as Morcher GmbH ofStuttgart, Germany, and Hanita Lenses of Hanita, Israel. The capsularbag implant (endocapsular tension ring) comprises an open-ended loop ofpolymethylmethacrylate (PMMA) which is resilient to compression in theradial direction within the capsular bag. The capsular bag implant isadapted to be implanted in the residual capsular bag before or after thecataractous lens is removed, and to engage the inner peripheral surfaceof the residual capsular bag to prevent shrinkage. The general circularexpansion of the capsular bag as provided by the capsular bag implant ispurported to improve stabilization of the intraocular environment andlens centration during intraocular surgery in patients with limitedzonular dialysis or generalized zonular weakness. The capsular bagimplant may be sutured to the scleral wall of the eye by passing a looparound the endocapsular tension ring and then passing the suture throughthe annular anterior capsulorhexis flap or the peripheral edge of thecapsular bag. However, passing a suture through the residual capsularbag jeopardizes the residual capsular bag's integrity and thereforejeopardizes long-term IOL centration and stabilization.

U.S. Pat. No. 5,843,184 to Cionni describes another endocapsular tensionring, purported to provide long-term stabilization and centralization ofthe capsular bag during and after intraocular surgery in patients havingmissing or damaged zonules. The endocapsular tension ring includes anopen-ended loop formed of biocompatible material that is constructed tobe resilient to compression in the radial direction within the capsularbag to prevent shrinkage of the capsular bag during and afterintraocular surgery. The improved endocapsular tension ring includes afixation element joined to the open-ended loop that is adapted to beattached to the scleral wall of the eye and thereby stabilize andcentralize the capsular bag within the posterior chamber of the eyewithout passing sutures through the capsular bag.

U.S. Pat. No. 6,183,480 to Mackool describes a stabilizer or fixationdevice. The stabilizer includes a shaft, a stabilizing bend extendingfrom the shaft, and a shank terminating at a termination end. The bendis between the shank and the shaft and is configured to provide ahook-like configuration to the stabilizer. A distance between a troughof the stabilizing bend and the termination end is between 1.6 mm and5.0 mm, preferably about 2.5 mm and between 2.0 mm and 3.0 mm. TheMackool device is designed for temporary fixation and is not a devicewhich may be permanently left in the eye.

SUMMARY OF THE INVENTION

The present invention seeks to provide novel intraocular clip that maybe used to affix the capsular bag to adjoining ocular tissue, as isdescribed more in detail hereinbelow.

There is thus provided in accordance with an embodiment of the inventionapparatus including an intraocular clip including first and second hookmembers extending generally coplanarly in opposite directions from aspine, the spine being formed with an attachment member attachable toocular structure.

In accordance with an embodiment of the invention a curved crook may beformed between each of the hook members and one end of the spine and theattachment member may be positioned adjacent an opposite end of thespine. The hook members may include arms spaced from the spine onopposite sides of the spine. The arms may be generally parallel to thespine, or alternatively, may be tilted at a non-zero angle with respectto the spine.

Further in accordance with an embodiment of the invention the attachmentmember may include an enlarged head with at least one hole formedtherethrough. The attachment member may include a pair of holessymmetric about a longitudinal axis of the spine.

The enlarged head may or may not protrude outwards beyond an outer edgeof the hook members.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be understood and appreciated more fully fromthe following detailed description, taken in conjunction with thedrawings in which:

FIG. 1 is a simplified pictorial illustration of an intraocular clip,constructed and operative in accordance with an embodiment of thepresent invention;

FIG. 2 is a simplified pictorial illustration of an intraocular clip,constructed and operative in accordance with another embodiment of thepresent invention;

FIG. 3 is a simplified pictorial illustration of an intraocular clip,constructed and operative in accordance with yet another embodiment ofthe present invention;

FIG. 4 is a simplified pictorial illustration of an intraocular clip,constructed and operative in accordance with still another embodiment ofthe present invention; and

FIG. 5 is a simplified pictorial illustration of an intraocular clip,constructed and operative in accordance with another embodiment of thepresent invention.

DETAILED DESCRIPTION OF EMBODIMENTS

Reference is now made to FIG. 1, which illustrates an intraocular clip10, constructed and operative in accordance with an embodiment of thepresent invention.

The intraocular clip 10 may include first and second hook members 12 and14 extending in opposite directions from a spine 16. The first andsecond hook members 12 may be generally coplanar with spine 16. In theillustrated non-limiting embodiment, spine 16 is common to, that is,shared by both hook members 12 and 14. A curved crook 18 may be formedbetween each of hook members 12 and 14 and one end 20 of spine 16. Eachof the hook members 12 and 14 may include arms 22 spaced from spine 16on opposite sides of spine 16. In the illustrated non-limitingembodiment, the arms 22 are generally parallel to spine 16.

The intraocular clip 10 may be constructed of a biologically compatiblematerial, such as but not limited to, polymethylmethacrylate (PMMA),silicone, silicone rubber, collagen, hydrogel, hyaluronic acid(including the sodium, potassium and other salts thereof), polysulfones,thermolabile materials and other relatively hard or relatively soft andflexible biologically inert optical materials. The intraocular clip 10may be transparent or may be colored to be translucent to aid thesurgeon during installation thereof.

The intraocular clip 10 may have any length, width and thicknesssuitable for intraocular insertion.

The spine 16 may be formed with an attachment member 24 attachable toocular structure. The attachment member may be positioned adjacent anopposite end 23 of spine 16. The attachment member 24 may include anenlarged head 25 with at least one hole 26 formed therethrough. In theillustrated non-limiting embodiment, the attachment member 24 includes apair of holes 26 symmetric about a longitudinal axis 28 of spine 16. Inthe embodiment of FIG. 1, the enlarged head 25 does not protrudeoutwards beyond an outer edge of hook members 12 and 14.

Reference is now made to FIGS. 2-4, which illustrate non-limitingvariations of the intraocular clip 10, constructed and operative inaccordance with other embodiments of the present invention.

In the embodiment of FIG. 2, the curved crooks 18 are elongated. In theembodiment of FIG. 3, the arms 22 are tilted at a non-zero angle withrespect to spine 16. In addition, the enlarged head 25 protrudesoutwards beyond an outer edge of at least one (e.g., both) of the hookmembers 12 and 14.

In the embodiment of FIG. 4, the spine 16 comprises two legs 30 and 32,wherein the first hook member 12 extends from leg 30 and the second hookmember 14 extends from the other leg 32. In the embodiment of FIG. 5,one or more holes 26 may be formed near end 20 of spine 16, throughwhich sutures may be passed. The enlarged head 25 may be formed with awavy or curved contour, which may be used for wrapping suturestherearound. It is emphasized that these are just some exemplaryembodiments, and the invention is not limited to these examples.

During cataract surgery, the clip may be inserted through a standardincision used for inserting IOLs (e.g., 3 mm). As another example, theintraocular clip 10 may be inserted through the opening made by thecapsulorhexis, such as the annular anterior capsulorhexis flap or theperipheral edge of the capsular bag. The intraocular clip 10 may clipthe capsular bag in paper-clip fashion. For example, as seen in FIG. 2,the intraocular clip 10 may be hooked onto a capsular bag 40 such thatthe hook members 12 and 14 are inside the capsular bag 40, while thespine 16 is outside the capsular bag 40. The intraocular clip 10 may beaffixed with a suture 42 that passes through the holes 26 and which istied to ocular structure 44, such as but not limited to, the sulcus,scleral wall or other tissue near the iris or cornea. Additionally oralternatively, suture 42 may be wrapped around the spine 16 or any otherportion of clip 10. Safety sutures may be temporarily wrapped around anyportion of clip 10 or passed through other holes formed in clip 10. Thesuture may also be used as a preventative measure to prevent the clip 10from dropping.

In some situations, one clip may be used. In other situations, two ormore clips may be used to symmetrically attach the capsular bag to theocular structure. The clips may pull vectorially on the capsular bag andmay help center it. The clips may be used before or after insertion ofthe IOL into the capsular bag. The procedure is reversible, and theclips may be removed. The position of the bag may be adjusted bytightening or loosening the sutures when suturing the clip.

The clips may also be used as a corrective measure in cases where a lenswas implanted in the past and became decentered. The clip may be usedwith or without an endocapsular ring. The clip may be used before orafter installing an endocapsular ring, before or after installing anIOL, or before or after removal of the crystalline lens. The clip may beused for temporarily clipping and widening the iris, for example.

The scope of the present invention includes both combinations andsubcombinations of the features described hereinabove as well asmodifications and variations thereof which would occur to a person ofskill in the art upon reading the foregoing description and which arenot in the prior art.

1-11. (canceled)
 12. A method comprising: providing an intraocular clipcomprising first and second generally planar hook members extendinggenerally coplanarly in opposite directions from a generally planarspine, said spine being formed with an attachment member attachable toocular structure; inserting said intraocular clip into an eye; andclipping said intraocular clip onto a capsular bag in paper-clip fashionby hooking said intraocular clip onto the capsular bag such that saidhook members and said spine are on different sides of capsular bag. 13.The method according to claim 12, wherein said intraocular clip ishooked onto the capsular bag such that the hook members are inside thecapsular bag, while the spine is outside the capsular bag.
 14. Themethod according to claim 12, further comprising affixing saidintraocular clip with a suture that passes through holes formed in saidintraocular clip and tying said suture to ocular structure comprising atleast one of a sulcus, a scleral wall and tissue near an iris or acornea of the eye.
 15. The method according to claim 14, furthercomprising wrapping said suture around a portion of said intraocularclip.
 16. The method according to claim 12, further comprising attachingtwo or more said intraocular clips to the capsular bag to symmetricallyattach the capsular bag to ocular structure.
 17. The method according toclaim 12, wherein said first and second generally planar hook membersand said spine each have a non-circular cross section.